COMBINED BIPOLAR VAPORIZATION AND RESECTION IN TREATMENT OF BPH

You have accessJournal of UrologyBPH & Bladder Outlet Obstruction (V08)1 Apr 2020V08-05 COMBINED BIPOLAR VAPORIZATION AND RESECTION IN TREATMENT OF BPH Osama Abdelwahab*, Tarek Soliman, Hammoda Sherif, Mohamed Habous, and Mohanad Aboanza Osama Abdelwahab*Osama Abdelwahab* More articles by this author , Tarek SolimanTarek Soliman More articles by this author , Hammoda SherifHammoda Sherif More articles by this author , Mohamed HabousMohamed Habous More articles by this author , and Mohanad AboanzaMohanad Aboanza More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000909.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bipolar TURP by resection loop and vaporization button are commonly used nowadays for treatment of BPH because it causes less intraoperative bleeding, and avoids free water absorption. However, bipolar vaporization may be associated with increased operative time and postoperative morbidity. By adding resection, we can minimize operative time and clean prostatic fossa from prostatic tissue shreds making prostatic fossa more smooth and regular. This video demonstrated the technique of combined bipolar vaporization and resection in case of BPH. We compared results of combined Bipolar TURP using the resection loop and vaporization versus vaporization alone for BPH to determine the relative safety and efficacy of both technique. METHODS: 77 patients with BPH were included in this study and randomized to operation either by Olympus (Gyrus) Bipolar loop TURP and Olympus (Gyrus) Bipolar button vaporization (Group 1) 40 patients or Olympus (Gyrus) Bipolar button vaporization alone( Group 2) 37 patients. Inclusion criteria were; BPH with qmax <10ml/sec, IPSS score>18 and prostate volume >40 gm. All patients were evaluated preoperatively and at 1, 3 and 9 months postoperatively by IPSS, uroflowmetry and prostate ultrasound. Clavien complications and operative time were recorded. RESULTS: There was no significant difference as regard age (51 + 9.9 and 52.5 + 8.2), hospital stay (1-2 days) or catheterization period (1-2 days) in both groups. Preoperative prostate volume (58 g v 55 g p=0.51) and IPSS (20 v 22 p=0.38) was equivalent. Significant increase in operative time was noticed in Group 2 (79± 15 minutes range 45-105 p <0.001), versus (mean 59 ± 10 minutes range 35-75 minutes, smale non-significant difference in blood loss occurred in both Groups (0.8% compared to 0.9% drop in hemoglobin, p<0.55) but increased postoperative urinary frequency (75% in G2 vs 45% in G1 (p <0.001), hematuria with clots as long as 3 weeks after surgery (18% vs 2%, p <0.001s p=0.22), :) and postoperative urethral stricture (4% vs 0%). There was No significant difference in Q max improvement Qmax (20 cc/s vs 18 cc/s) or postoperative prostate volume (32 vs 31 g p=0.31) and IPSS (6 v 5 p=0.22) equivalently. CONCLUSIONS: Combined Bipolar vaporization and resection of the prostate, is superior to Bipolar Vaporization alone as regard operative time and postoperative morbidity without compromising its efficacy and safety. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e735-e735 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Osama Abdelwahab* More articles by this author Tarek Soliman More articles by this author Hammoda Sherif More articles by this author Mohamed Habous More articles by this author Mohanad Aboanza More articles by this author Expand All Advertisement PDF downloadLoading ...